Development and Evaluation of a Chronic Care Competency Scale for Primary Care Team in Thailand

Abstract

                 The Thai health care system currently has no tool available to measure chronic care competency in primary care settings. This research aimed to develop a conceptual structure and evaluate a Chronic Care Competency Scale (CCCS) for primary care teams in Thailand. The CCCS was developed using a concept analysis from literature reviews. In-depth interviews of Thai primary care team members were used to form the specified domains, which were used to generate an item pool consisting of 50 items whose content validity was tested by 9 experts (CVI = 0.95).  The retained 40-item CCCS was further evaluated by 35 primary care team members and yielded high internal consistency (α= 0.98).

                The field test was conducted in 434 primary care team members, resulting in a high reliability of the 40-item CCCS (α = 0.97). The exploratory factor analysis (EFA) was used to test its construct validity; the final version of the 40-item CCCS revealed three domains: 1) basic medical care, 2) health risk management and symptom control, and 3) community resources management. The construct validity evaluation using hypothesis testing reported a positive correlation between years of education and the total CCC scores (r = 0.58, p< 0.01). Moreover, the stability evaluation, using the test-retest method, demonstrated a correlation between time 1 and time 2 testing (r = 0.90, p< 0.01).

               Therefore, the CCCS can be used to measure the chronic care competency for Thai primary care teams such as nurses since it demonstrated adequate validity and reliability.